Background Enhanced recovery program (ERP) has demonstrated improved postoperative outcomes with increased adherence to pathway. However, there is scarce data on feasibility and safety in resource limited setting. The objective was to assess compliance with ERP and its impact on postoperative outcomes and return to intended oncological treatment (RIOT). Methods A single center prospective observational audit was conducted from 2014–2019, in elective colorectal cancer surgery. Before implementation, multi-disciplinary team was educated regarding ERP. Adherence to ERP protocol and its elements was recorded. Impact of quantum of adherence (≥ 80% vs.